Muscle stimulators.
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Electric Stimulation↗
Biomedical subjects
L Snyder-Mackler
Publications and source records attributed to L Snyder-Mackler.
Effects of helium-neon laser irradiation on skin resistance and pain in patients with trigger points in the neck or back.
The purpose of this double-blind study was to ascertain the effects of helium-neon (He-Ne) laser irradiation on skin resistance and pain in patients with trigger points in the neck or low back. This study entailed a partial replication of a previous study by Snyder-Mackler and associates that determined the use of the He-Ne laser increased skin resistance overlying a trigger point. Twenty-four patients were randomly assigned to either a treatment or a control group and received three 20-second applications of laser irradiation or placebo "stimulation," respectively. Pretreatment and posttreatment skin resistance and pain measurements (via visual analog scale) were taken during each session. Results indicated a statistically significant increase in skin resistance (p less than .001) and a decrease in pain (p less than .005) following laser treatment. There was not a significant correlation between skin resistance and pain across subjects. These data substantiate the previous findings of Snyder-Mackler and associates and demonstrate a reduction in pain. Helium-neon laser treatment, therefore, may be an effective adjunct to conventional physical therapy of these patients.
Double-Blind Method↗
Bilateral analysis of the knee and ankle during gait: an examination of the relationship between lateral dominance and symmetry.
This study examined the relationship between lower extremity dominance and kinematic symmetry during gait. Fourteen healthy volunteers without any observable gait deviations participated in the study. The subjects (8 male, 6 female) ranged in age from 19 to 56 years. Lower extremity lateral dominance was determined using an assessment method developed by Carol Coogler. Retroreflective spherical markers were placed bilaterally at points over the greater trochanter, the lateral joint line of the knee, the lateral malleolus, and the metatarsal break. A video-based data-acquisition instrument interfaced with a PDP 11/73 computer measured 12 kinematic variables while the subjects walked at self-selected speeds along a 10-m walkway. A multivariate analysis of variance with one repeated measure revealed significant differences between limbs, across subjects, for stance time and maximum knee extension. A within-subject analysis demonstrated significant differences for 10 variables; however, lateral dominance could not be related predictably to these variations. Our results indicate that symmetry cannot be generalized in view of intrasubject variability for these variables. [Valle DR, Gundersen LA, Barr AE, et al: Bilateral analysis of the knee and ankle during gait: An examination of the relationship between lateral dominance and symmetry.
Adult↗
Rehabilitation of the athlete with low back dysfunction.
Low back injuries in athletes can be classified into three diagnostic categories: disk problems, hypomobility/hypermobility problems, and muscular problems. Various strategies have been presented for the identification and treatment of these disorders. The translation of rehabilitation procedures to an athletic population including resumption of training and competition have been discussed.
Age Factors↗
Effect of helium-neon laser irradiation on peripheral sensory nerve latency.
The purpose of this randomized, double-blind study was to determine the effect of a helium-neon (He-Ne) laser on latency of peripheral sensory nerve. Forty healthy subjects with no history of right upper extremity pathological conditions were assigned to either a Laser or a Placebo Group. Six 1-cm2 blocks along a 12-cm segment of the subjects' right superficial radial nerve received 20-second applications of either the He-Ne laser or a placebo. We assessed differences between pretest and posttest latencies with t tests for correlated and independent samples. The Laser Group showed a statistically significant increase in latency that corresponded to a decrease in sensory nerve conduction velocity. Short-duration He-Ne laser application significantly increased the distal latency of the superficial radial nerve. This finding provides information about the mechanism of the reported pain-relieving effect of the He-Ne laser.
Adult↗
Clinical application of electrotherapeutic modalities.
The purposes of this survey study were 1) to determine the frequency of use of eight forms of electrical stimulation and ultrasound in clinical practice and 2) to determine the factors that influence how and when these forms of electrical stimulation are used. A survey questionnaire was distributed to 490 physical therapists in clinics affiliated with the academic programs of Ithaca College and Temple University. Forty-five percent (221) of the distributed surveys were returned. Descriptive statistics and chi-square calculations were used in the data analysis. Respondents frequently used two forms of pulsed current and rarely used two forms of alternating current. No form of electrical current was used as frequently as ultrasound. The frequency and type of electrical stimulation used depended on the availability of electrical stimulators and the adequacy of entry-level training in electrotherapy. The results of this study suggest the need for additional electrical stimulators in physical therapy clinics, training for physical therapists, and research in electrotherapy.
Electric Stimulation↗
Effect of helium-neon laser on musculoskeletal trigger points.
Cold lasers have been proposed recently as a therapeutic tool for treating a wide variety of pathological conditions, including wounds, arthritis, orthopedic problems, and pain. These proposed therapeutic effects largely have been unsubstantiated by research. A randomized, double blind study was undertaken to ascertain the effect of a helium-neon (He-Ne) laser on the resistance of areas of skin overlying musculoskeletal trigger points. These areas usually demonstrate decreased skin resistance when compared with the surrounding tissue. Thirty patients with musculoskeletal trigger points were assigned randomly to either an experimental or a placebo group. In addition to standard physical therapy, each patient received three 15-second applications of a He-Ne laser or placebo "stimulation" from an identical unit that did not emit a laser. The results of a two-way analysis of covariance with one repeated measure showed a statistically significant increase (p less than .007) in skin resistance. This increase in an abnormal skin resistance pattern may accompany the resolution of pathological conditions.
Adolescent↗
Effect of standard and Aircast tennis elbow bands on integrated electromyography of forearm extensor musculature proximal to the bands.
Classic tennis elbow, or lateral epicondylitis, has been described as an overuse or misuse injury resulting in a tendinitis. The extensor carpi radialis brevis (ECRB) and extensor digitorum communis (EDC) have been implicated as primary culprits in this pathology. Tennis elbow has been treated using a constrictive band placed several centimeters distal to the origin of these two muscles. Aircast (Aircast Inc., Summit, NJ) has developed a new style of band that employs an air-filled bladder as the counterpressure element. This study tested the effect of both standard and Aircast bands on EMG activity of the EDC and ECRB proximal to the band compared to control values. Ten normal subjects, ranging in age from 20 to 43 years, were tested. Right upper extremities were tested in all cases. The subjects' forearms were stabilized in the CYBEX II forearm stabilization V-pad. The ECRB and EDC were then impaled with monopolar EMG needle electrodes. The CYBEX data were recorded using the HUMAC system and the EMG data were recorded and analyzed using the Cadwell 7400. EMG data were recorded at 80% of maximum voluntary isometric contraction (MVIC) with no band, the standard band, and the Aircast band. An analysis of variance (ANOVA) with repeated measures of integrated EMG (IEMG) and Duncan's multiple comparison tests revealed that the Aircast caused a significant reduction in IEMG of the ECRB and EDC when compared with control values and the standard band. The decrease in IEMG with the standard band was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Fate of the ACL-injured patient: a prospective outcome study.
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Anterior Cruciate Ligament↗
Development of a distance-based interval throwing program for Little League-aged athletes.
We developed a distance-based interval throwing program for Little League-aged athletes (9 to 12 years) to be used in training and rehabilitation. The timing and repetition parameters were developed from data collected during 400 innings of organized baseball during a single season, and short toss distance from Little League rules for field dimensions. There were 1022 boys from organized baseball teams in the four studies. Maximal distance and speed measurements were recorded for 853 boys. We developed a mathematical model from these data to predict maximal throwing distance from maximal throwing speed. This model was then tested on a second sample of 114 players. We compared the predicted distance with the actual maximal throwing distance; the correlation coefficient was 0.92. Forty players aged 9 to 12 participated in a study to assess degradation of speed and distance. The average variability of the speed was small (< 5 mph), but the variability in distance was large (22.4 feet). Fifteen boys then threw the entire throwing program as designed. These results show that healthy young athletes can be expected to be able to throw the predicted value of this practical progressive interval throwing program for Little League-aged athletes. The appropriate program can be assigned from age and known preinjury pitch speed.
Adolescent↗
The relationship between passive joint laxity and functional outcome after anterior cruciate ligament injury.
Twenty patients with anterior cruciate ligament-deficient knees were studied. Ten patients returned to all sports activities (compensators) and 10 patients were not improved with nonoperative management and required surgical stabilization (noncompensators). Joint laxity was measured using a KT-2000 arthrometer (manual maximum Lachman). Subjects completed a Lysholm questionnaire and Knee Outcome Score. The International Knee Documentation Committee form was also completed. Patients also rated their knee function on a scale of 1 to 100. There was no difference in level and frequency of athletic activity between the two groups before their anterior cruciate ligament injuries as determined by the knee outcome score. The compensator group had a mean side-to-side difference of 3.25 mm at 89 N and the noncompensators had a mean difference of 3 mm preoperatively. Manual maximum tests gave side-to-side differences of 6.7 mm for the compensators and 6 mm for the noncompensators. There were no differences in laxity measures between groups. The correlation between knee outcome scores and side-to-side laxity measurements were not significant. Measurements of anterior laxity in anterior cruciate ligament-deficient patients were not correlated with measures of functional outcome used in this study. Functional outcome measurements that are partially based on joint laxity measures, such as the International Knee Documentation Committee form, may artificially overestimate the disability after anterior cruciate ligament rupture.
Adolescent↗
Upper extremity weight-training modifications for the injured athlete. A clinical perspective.
The ability of the health care professional to make correct decisions about the progression of weight-training is critical to the rehabilitation process. The purpose of this article is to describe our approach to modification of weight-lifting techniques using the injured shoulder as a model. Additionally, the impact of various upper extremity weight-training techniques on healthy athletes is discussed. The effects of grip, hand spacing, bar trajectory, and start and finishing positions on microtraumatic injury and return to weight-training activities after injury are considered. Several weight-training functional progressions for common multijoint exercises (such as bench press, shoulder press, power clean) are presented. Adaptations for periodization are also presented for implementation in the rehabilitation sequence. The weight-training modifications described in this paper will assist the health professional to safely return athletes to the weight room after shoulder injury.
Adaptation, Physiological↗